First Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, University of Athens, Athens, Greece.
Int J Gynecol Cancer. 2012 Jun;22(5):742-7. doi: 10.1097/IGC.0b013e31825104bd.
This study aimed to determine whether 3q26 gain can predict which low-grade squamous intraepithelial lesions (LSILs) and atypical squamous cells of undetermined significance (ASCUSs) will progress to higher-grade squamous intraepithelial lesion (HSIL).
Liquid cytology specimens of LSIL and ASCUS from 73 women were examined using fluorescent in situ hybridization (FISH) for the detection of 3q26 gain. All women underwent colposcopy and biopsy at the initial visit and 40 of them with histology showing cervical intraepithelial neoplasia 1 (CIN 1) or human papillomavirus infection (koilocytosis) were included in the study. They were reevaluated with liquid cytology, colposcopy, and biopsy after a median follow-up of 17.5 months.
A total of 40 cases were analyzed (31 LSILs and 9 ASCUSs). Of these cases, 8 (20%; 6 LSILs and 2 ASCUSs) were positive and 32 (80%) were negative for 3q26 gain according to FISH. Three of the 8 positive women (38%) progressed to HSIL/CIN 2 or worse, whereas none of the 32 negative women did so. 3q26 gain could predict progression with a negative predictive value of 100% (95% confidence interval, 89.1%-100%). In addition, women positive for 3q26 gain had a significantly lower regression rate compared with negative women (P = 0.009).
In this first prospective study, 3q26 gain in LSIL/ASCUS cytology exhibited an impressive negative predictive value for progression to HSIL/CIN 2 or worse. Thus, 3q26 gain may be useful in stratifying patients' risk for progression and possibly alter management and reduce cost of follow-up.
本研究旨在确定 3q26 增益是否可以预测哪些低级别鳞状上皮内病变（LSIL）和不明确意义的非典型鳞状细胞（ASCUS）会进展为高级别鳞状上皮内病变（HSIL）。
使用荧光原位杂交（FISH）检测 73 名女性的 LSIL 和 ASCUS 的液基细胞学标本中 3q26 的增益。所有女性在初次就诊时均接受阴道镜检查和活检，其中 40 名女性的组织学显示宫颈上皮内瘤变 1 级（CIN1）或人乳头瘤病毒感染（挖空细胞），包括在研究中。在中位随访 17.5 个月后，对这些患者进行了液基细胞学、阴道镜和活检复查。
共分析了 40 例病例（31 例 LSIL 和 9 例 ASCUS）。根据 FISH，这些病例中 8 例（20%；6 例 LSIL 和 2 例 ASCUS）为 3q26 增益阳性，32 例（80%）为阴性。8 例阳性女性中有 3 例（38%）进展为 HSIL/CIN2 或更高级别病变，而 32 例阴性女性中无一例进展。3q26 增益的阴性预测值为 100%（95%置信区间，89.1%-100%），可以准确预测进展。此外，与阴性女性相比，3q26 增益阳性的女性的消退率显著较低（P=0.009）。
在这项首次前瞻性研究中，LSIL/ASCUS 细胞学中的 3q26 增益对进展为 HSIL/CIN2 或更高级别病变具有令人印象深刻的阴性预测值。因此，3q26 增益可能有助于对患者进展风险进行分层，并可能改变管理方式，降低随访成本。
